Riccardo Antonio Lencioni MD, Presenter: Nothing to Disclose

Claudio Vignali MD, Abstract Co-Author: Nothing to Disclose

Laura Crocetti MD, Abstract Co-Author: Nothing to Disclose

Pasquale Petruzzi, Abstract Co-Author: Nothing to Disclose

Elena Bozzi MD, Abstract Co-Author: Nothing to Disclose

Roberto Cioni MD, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Previous experimental work in animal models demonstrated a significant dose-dependent increase in radiofrequency ablation (RFA)-induced coagulation necrosis with intravenous or direct intratumoral administration of doxorubicin. Purpose of this clinical study is to investigate feasibility, safety, and effectiveness of RFA combined with doxorubicin eluting beads arterial embolization in the treatment of hepatocellular carcinoma (HCC).

Twenty patients with single HCC > 3 cm showing clear-cut evidence of residual viable tumor at CT or MR imaging obtained immediately after RFA were scheduled for doxorubicin eluting beads arterial embolization. The patient population comprised 14 males and 6 females (63-83 years old; mean, 70 years ± 6). Tumor size ranged 3.3-7.0 cm (mean, 5.0 cm ± 1.4). RFA was performed by using expandable multitined electrodes (RITA Medical Systems) according to manufacturer's protocols. Arterial embolization was performed 24 hours after RFA by using 50-125 mg doxorubicin loaded in either 100-300 or 300-500 µm beads (DC Bead ®; Biocompatibles UK Ltd). Treatment efficacy was evaluated by CT and MRI at 1 month and at 3-month intervals during the follow-up (follow up range, 3-16 months; mean, 9.0 months ± 4.5).

Treatment protocol was successfully completed in all patients. One patient developed hepatic infarction that did not require any treatment. The range of volumes of unenhancing tissue representing coagulation necrosis increased from 48.8 cm3 ± 35.7 after RFA alone to 75.5 cm3 ± 52.4 after doxorubicin eluting beads arterial embolization, with an increase of 60.9% ± 39.0. The increase in unenhancing volume resulted in complete ablation of 14 (70%) of 20 tumors. One patient developed local tumor progression and one patient developed new HCC lesions. Sustained complete response was observed in 13 (65%) of 20 patients. Overall 1-year survival was 100%.

Combined RFA and doxorubicin eluting beads arterial chemoembolization is a safe and effective treatment for large HCC.

Combined RFA and doxorubicin eluting beads arterial chemoembolization is a safe and effective treatment for large HCC.

Lencioni, R, Vignali, C, Crocetti, L, Petruzzi, P, Bozzi, E, Cioni, R, Bartolozzi, C, et al, , et al, , Radiofrequency Ablation Combined with Doxorubicin Eluting Beads Arterial Chemoembolization in the Treatment of Hepatocellular Carcinoma: A Pilot Clinical Trial.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012402.html